Unintended use of prescription medications by the intended user or others is a serious problem. The misuse of legitimately prescribed medications such as painkillers, stimulants, tranquilizers, sedatives, and steroids kills tens of thousands of Americans and costs the U.S. healthcare system more than $100 billion a year. The biggest impact is from opiate painkillers, but deaths and injuries are often caused by simultaneous exposure to multiple classes of Controlled Substances and drugs of potential abuse. Opiates remain the medications of choice to treat legitimate acute and chronic pain. In the U.S. alone, 130 million prescriptions were written in 2010 for hydrocodone, which has become a widespread source of abuse and drug trafficking. All told, approximately 500 million Controlled Substance prescriptions are written in the U.S. each year. According to recent congressional data, prescription drug abuse is the leading cause of accidental death in the U.S., now exceeding traffic accidents, and also exceeding deaths from heroin and cocaine, combined. Approximately 60% of prescribed medication is not taken as directed.
In 2010, over 38,000 unintentional drug overdose deaths occurred in the United States, 60% of those involving prescription medications. Prescription drug abuse is the fastest growing drug problem in the United States. The increase in unintentional drug overdose death rates in recent years has been driven by increased use of a class of prescription opioid analgesics. In addition, recent data suggests that for every unintentional overdose death related to an opioid analgesic, 10 persons are admitted for substance abuse treatment, 32 visit emergency departments, 130 report drug abuse or dependence, and 825 report nonmedical uses of opioid analgesics. Prescription drugs are the second-most abused category of drugs after marijuana.
Medications, such as opioid analgesics and narcotics, may be prone to abuse or diversion, for instance taken in excess or diverted and sold to others who would abuse the medication. The two main populations in the United States at risk for prescription drug overdose are the approximately 9 million persons who report long-term medical use of opioids and the roughly 12 million persons who report non-medical use (i.e., use without a prescription or medical need) annually. In an attempt to treat patient pain better, practitioners have greatly increased their rate of opioid prescribing over the past decade. Persons who abuse opioids have learned to exploit this new practitioner sensitivity to patient pain, and clinicians struggle to treat patients without overprescribing these drugs. The regulatory response to inform the prescriber about the potential abusers recent prescription history through an updated electronic health record is currently part of the attempt to address one aspect of this problem. This, however, still does not address the availability of the entire contents of a legitimately prescribed opioid capped bottle to anyone once it's opened, in any amount, at any frequency. The chain of command for the drug of potential abuse is lost once it leaves the pharmacy.
It is desirable to prevent the misuse of medications by intended users and also to ensure correct dispensing of prescription medications. It would be useful to provide a low-cost portable dispenser and monitoring system to verify that medications stored therein are not taken in excess (i.e., abused) and are only taken at the prescribed interval and dose. It also would be useful to provide a portable dispenser and monitoring system to verify that medications stored therein are removed only by the patient or another authorized person in order to prevent drug abuse and diversion.